Sclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation
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Sclerosing pancreatitis might develop repeatedly or might rapidly extend to the whole pancreas with recurrent mass formation.
Nothing is known concerning course or development of sclerosing pancreatitis.
A 63-yr-old male was followed up for 2.5 yr.
The patient was admitted because of a tumor in the body and tail of the pancreas. Serum pancreatic enzymes were transiently elevated, but tumor markers were all negative. Imaging studies showed a tumor 7 cm in size. The main pancreatic duct was normal in the head and obstructed at the body on endoscopic retrograde pancreatography (ERCP). The K-ras oncogene mutation was positive in pure pancreatic juice. Distal pancreatectomy was performed because pancreatic cancer was highly suspected. Pathological findings showed that the tumor was a densely fibrotic mass without malignant cells. Inflammatory cell infiltration was observed in the stroma. One year later, another mass 3 cm in size was noted in the remnant pancreatic head. ERCP revealed diffuse irregular narrowing of the main pancreatic duct, its branches, and the common bile duct. Liver dysfunction improved and an elevation of serum pancreatic enzymes subsided without any specific treatment, and the mass diminished in size. The patterns of various imaging studies on the second tumor were the same as those of the previous resected mass. Corticosteroid was not administered.
Key WordsSclerosing pancreatitis recurrence pancreatectomy mass-forming pancreatitis tumor-forming pancreatitis autoimmune pancreatitis
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- 6.Iwabe C, Watanabe S, Toki F, Shiratori K, Hayashi N, Karasawa E. A case of successful corticosteroid treatment of chronic pancreatitis with diffuse irregular narrowing of the main pancreatic duct complicated by Sjögren's syndrome.J Jpn Panc Soc 1996; 11: 45–55 (in Japanese with English abstract).Google Scholar
- 12.Sato T, Ikeda M, Ochiai M, Ikeda M, Morozumi A, Ainota T, Akahane Y, Fujino MA, Suda K, Matsumoto Y. A case of tumor-forming pancreatitis with marked lymphocytic infiltration.J Jpn Panc Soc 1993; 8: 219–224 (in Japanese with English abstract).Google Scholar
- 14.Watanabe H, Miyagi C, Yamaguchi Y, Satomura Y, Ohta H, Motoo Y, Okai T, Yoshimura T, Tsuji Y, Sawabu N, Detection of K-ras point mutation at codon 12 in pure pancreatic juice for the diagnosis of pancreatic cancer by hybridization protection assay (HPA): a simple method for the determination of the types of point mutations.Jpn J Cancer Res 1996; 87: 466–474.PubMedGoogle Scholar